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East Medical Center

Description

The Wellness Plan Medical Centers (TWP) plans to conduct the complete renovation of five medical units at the East Medical Center (EMC) in order to meet its goal of being a NCQA recognized Patient Centered Medical Home (PCMH). The current layout interferes with workflow, which creates bottlenecks and inefficiencies by isolating the clinical team from their support team. There have been no renovations of the facility since its construction 30 years ago. Upon completion, the renovation will have remodeled five medical units, five restrooms, and the registration department. It will also replace the HVAC unit, aging clinical equipment/furniture, and expand the facility’s information technology infrastructure.

A 2013 HRSA site visit recognized the near claustrophobic configuration of EMC exam rooms and the need for modernization. The current room configuration can make it difficult for parents with two or more children, obese adult patients, or patients with disabilities to be served. The rooms also create privacy issues for patients and providers. Twenty-eight smaller exam rooms will be combined to create 14 larger exam rooms. The new rooms will be outfitted with new furniture, sinks, and fixtures. All rooms will have new flooring, ceiling tiles, and fixtures. Six restrooms will be combined to create four larger ADA compliant restrooms in the clinical unit. In addition, the public restrooms will be completely renovated to create ADA compliant restrooms. New restrooms will include new fixtures and stalls with handrails.

Organization’s brief history, special characteristicsTWP has been providing health care services in Michigan for over 40 years. TWP is a Federally Qualified Health Center that owns and operates four medical centers that are strategically located to provide health care access to Wayne and Oakland County’s most vulnerable medically underserved men, women, and children. Currently, TWP experiences more than 45,000 patient encounters each year, while providing the highest quality primary care and preventive services to the uninsured and underinsured population of Southeast Michigan, regardless of their ability to pay. The organization also operates convenient on-site pharmacies at each location or provides home delivery. The pharmacy offers discounted drug pricing through the federal 340B program and pharmaceutical company discount programs. In addition, TWP provides full-service obstetrics and gynecology services for women, as well as comprehensive general and emergency dentistry services. TWP provides behavioral health services to patients in need. The organization’s outreach staff assists patients in enrolling in health insurance coverage through the Health Insurance Marketplace and Healthy Michigan, Michigan’s expanded Medicaid program. TWP successfully implemented EHS electronic medical records (EMR) in 2008, and is on track to achieve Stage 2 Meaningful Use designation and Level 1 Patient Centered Medical Home in 2015.

Reaching Special Populations

TWP’s service area includes approximately 407,000 residents. Southeast Michigan, including the City of Detroit, Wayne County, and the southern area of Oakland County, has experienced radical de-industrialization with the collapse of the auto industry, resulting in a dramatic upsurge in unemployment and poverty. The percentage of the population that is uninsured within the service area is 20.2%, and the national median benchmark is 14.1%. The overall age adjusted death rate of City residents is nearly 44% percent higher than the national rate. The Michigan Department of Community Health reports an excess mortality rate that is 24% higher in Detroit than the state, and more than double the rate for 15-59 year olds. Heart disease and cancer are responsible for more than half of all deaths. Almost all health indicators of Maternal and Child Health are nearly double the state rate. The City of Detroit low birth weight mortality rate of 10.0 is more than double the Michigan rate of 4.8 per 1,000. The infant mortality rate is 14.7, which is almost double the state rate of 7.5 per 1,000. More than 24% of hospital admissions in Detroit stem from conditions that are treatable in a primary care setting, which is 20% above the state average. Births to teenage mothers 15-19 years old make up 22.2% of births in the service area, compared to 6.3% as a national benchmark and 9.2% as a severe benchmark. These are considered high-risk births and require adequate prenatal care to ensure good outcomes.

Improving Outcomes

The renovation will lead to an expansion of TWP’s family medicine capability. The new family practitioner will see approximately 4,000 new patient encounters each year. The renovations will make the Center more accessible to obese and disabled patients, while setting the stage for more coordinated care between clinical and support staff.

Program Innovation / Model of Delivery

The organization provides medical, dental, and behavioral health care services, as well as health insurance enrollment assistance, all under one roof. TWP offers a one-stop-clinical-shop to Wayne and Oakland County residents. TWP also offers regular evening and weekend clinic hours to provide patients with an alternative to using the emergency room for services that can be provided by their primary care provider.

Community Collaboration / Service Integration

TWP has a long history of collaborating with area health systems and agencies, and cooperating in programs to better meet the needs of the medically underserved.

Innovation in Design

The lighting, HVAC, and other mechanical upgrades will be completed to meet high-energy efficiency standards. TWP will select furniture made from bio-degradable and reusable materials for this renovation project.

Impact on Social Determinants of Health

provide a significant boost in patient satisfaction and utilization by disabled, elderly, infirmed, and wheelchair bound patients. The renovations will add ADA compliant restrooms in the lobby waiting area and on the medical units.

Expanding the size of the current exam rooms will result in improved access for large families, obese patients, and disabled individuals. This will lead to greater satisfaction and utilization among patients who want their family members involved in the care process. This family-centric approach to treatment becomes practical once there is sufficient space and adequate facilities to accommodate family members.

TWP continues its outreach and enrollment services, assisting the uninsured with enrolling in the Healthy Michigan Plan and Health Insurance Marketplace, as well as providing the full range of FQHC enabling services.